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Observational Study
. 2024;53(8):641-649.
doi: 10.1159/000539808. Epub 2024 Jun 13.

Tachycardia and Acute Kidney Injury among Critically Ill Patients with Sepsis: A Prospective Observational Study

Naoki Hayase  1 , Miyuki Yamamoto  2 , Toshifumi Asada  2 , Rei Isshiki  3 , Kent Doi  2
Affiliations
Observational Study

Tachycardia and Acute Kidney Injury among Critically Ill Patients with Sepsis: A Prospective Observational Study

Naoki Hayase et al. Blood Purif. 2024.

Abstract

Introduction: Tachycardia caused by sympathetic overactivity impairs myocardial function and raises septic patients' mortality. This study examined whether tachycardia is associated with acute kidney injury (AKI) period-prevalence among critically ill patients with and without sepsis.

Methods: In 328 patients (119 sepsis and 209 non-sepsis) admitted to our intensive care unit (ICU), we assessed heart rate at ICU admission, plasma neutrophil gelatinase-associated lipocalin (NGAL) and N-terminal pro-B-type natriuretic peptide, and urinary L-type fatty acid-binding protein and N-acetyl-β-<sc>d</sc>-glucosaminidase (NAG) at 0 and 48 h after admission. Tachycardia was defined as a heart rate above 100 beats/min.

Results: Tachycardia was independently correlated with AKI prevalence during the first week after ICU admission in the septic patients, but not in the non-septic patients. A dose-dependent increase in AKI period-prevalence was observed across ascending heart rate ranges. Furthermore, we discovered a dose-dependent increase in renal biomarker-positive patients regarding plasma NGAL and urinary NAG over increasing heart rate ranges 48 h after admission.

Conclusion: The findings revealed an independent relationship between tachycardia and AKI prevalence during the first week of ICU in septic patients. Heart rate was found to have a dose-dependent effect on AKI prevalence and renal insult monitored by biomarkers.

Keywords: Acute kidney injury; Biomarker; Sepsis; Tachycardia.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Study flow diagram. ESRD, end-stage renal disease.
Fig. 2.
Fig. 2.
The prevalence of AKI within a week according to ascending ranges of heart rate at ICU admission among the septic patients. #p < 0.05 versus the reference range of 40–80 beats/min by χ2 test or Fisher’s exact test with Bonferroni post hoc test. AKI, acute kidney injury; ICU, intensive care unit.
Fig. 3.
Fig. 3.
Cardiorenal biomarkers across increasing heart rate ranges in the septic patients with complete data of the biomarkers.#p < 0.05 versus the reference range of 40–80 beats/min by χ2 test or Fisher’s exact test with Bonferroni post hoc test. L-FABP, L-type fatty acid-binding protein; NAG, N-acetyl-b-d-glucosaminidase; NGAL, neutrophil gelatinase-associated lipocalin; NT-proBNP, N-terminal pro-B-type natriuretic peptide.
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